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Organization
SPECIAL CARE DENTAL OF PENNSYLVANIA-CKK LLC
Active
Organization
SPECIAL CARE DENTAL OF PENNSYLVANIA-CKK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY L STEVENS (DIRECTOR OF REVENUE)
(502) 244-2441
Entity
Organization
Contact information
Practice address
11974 EDGEHILL TERRACE RD, PRINCESS ANNE, MD 21853-2105
(502) 244-2420
(502) 996-8282
Mailing address
12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY 40243-2404
(502) 813-4415
(502) 996-8282
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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